340B Drug Pricing Program Database
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DSH050158 ENCINO HOSPITAL (Terminated)
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Main Details
Name
ENCINO HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050158
Medicare Provider Number
050158
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/14/2017
Last Recertification Date
8/22/2018
Termination Date
Termination Reason
7/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Encino Hospital Medical Center
Bockhi Park, Chief Executive Officer
(818) 907-4540
Primary Contact
Encino Hospital Medical Center
Keith Sinn, Director- Pharmacy
(818) 974-6221
Addresses
Street Address
16237 VENTURA BLVD
ENCINO, CA 91436
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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